Medi-Cal: managed care.

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, pursuant to which medical benefits are provided to public assistance recipients and other low-income persons. Existing law provides for the department to enter into contracts with managed care systems, hospitals, and prepaid health plans for the provision of various Medi-Cal benefits. Existing law prohibits services covered by the California Children's Services program (CCS) from being incorporated into a Medi-Cal managed care contract entered into after August 1, 1994, until January 1, 2012, except with respect to contracts entered into for county organized health systems in specified counties. This bill would extend to January 1, 2016, the termination of the prohibition against CCS covered services being incorporated into a Medi-Cal managed care contract entered into after August 1, 1994. Existing law requires the provider rates of payment for services rendered for the Healthy Families Program to be identical to the rates of payment for the same service performed by the same provider type pursuant to the Medi-Cal program if the services are provided by a Medi-Cal provider. This bill would require identical rates only if the service was provided by a Medi-Cal provider pursuant to specified contracts.